New York Life

New York Life gets away with denying STD when LTD is denied

Reviewed by Sharon on March 14th 2011   Verified Policyholder
I have had chronic back pain for years and recvd treatment for over a year of injections, chiro, etc. On Oct 5 2010 I had lower lumbar diskectomy and with lamintomy decompression on right and left side of spine. New York Life paid my STD thru 1/13/11 but reviewed for LTD in Jan. and denied me LTD due to not enough medical info to support my claim regardless of further testing being scheduled to determine the etiology of my pain. I have been unable to stand or walk for any significant amout of time and still have severe low back pain. I am a restaurant manager. New York Life stated that MRI done on 12/9/10 was unremarkable even though it did show a re herniation of disc that was involved in surgery. Once the LTD was denied they automatically denied my STD benefits which were payable until 3/14/11. Because this is employer supplied with me paying extra for higher payout, my job is now on the line and a PDc form had to be filled out for employer to determine if I am protected under FMLA since they go by New York Life's approval date. I submitted an appeal letter (Denial stated that I had to submit an appeal on my own before obtaining legal rep. according to our contract) and told her on Monday that I would be adding the Mylogram CT report this week once I heard from my doctor. My dr. told me I may need a second surgery depending on this test. I received a copy of Mylogram report and it looks as though the same disc showing on MRI is still herniated and nerve root sleeves are indented on both left and right side with the right side indented enough to prevent filling of contrast. Everything else is scar tissue. My job requires me to be on my feet on avg 7-8 of 10 hour shifts and is a one hour drive one way to work. I am on the verge of losing everything, my fiance lost his job first of Feb. and we have went from over 4000 month to 0 dollars per month. How can they do a across the board denial of STD because LTD is denied? I just do not understand, this is why people get disability insurance.
Reply
Sent on March 14th 2011 by Attorney Gregory Dell

Sharon, New York Life is notorious for disability claim denials such as yours. It sounds like you have a lot of medical evidence in support of your claim. In order for us to determine if we can assist you, we need to review your denial letter. It sounds like New York Life is trying to strong-arm you.